Chemokine (C-C Motif) Ligand 14 to Predict Persistent Severe Acute Kidney Injury: A Systematic Review and Meta-Analysis.

IF 2.2 3区医学 Q3 HEMATOLOGY Blood Purification Pub Date : 2024-08-24 DOI:10.1159/000541058

Nicolas Tebib, Céline Monard, Thomas Rimmelé, Antoine Schneider

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Abstract

Introduction: In this systematic review and meta-analysis, we aimed to review available data and provide pooled estimates of the predictive performance of urinary chemokine (C-C motif) ligand (uCCL14) for persistent (≥48 h) severe acute kidney injury (PS-AKI).

Methods: We searched MEDLINE, PubMed, Cochrane Library, and EMBASE for studies published up to April 11, 2023. We considered all studies including adults and reporting on the ability of uCCL14 to predict PS-AKI as defined by AKI persisting for 48 or 72 h. Data extraction was performed by one investigator using a standardized form. It was checked for adequacy and completeness by another investigator.

Results: After screening, we identified 13 relevant studies. Among those, four (561 patients) provided sufficient data regarding the outcome of interest and were included. Considering each study cutoff value, pooled sensitivity and specificity were 0.85 (95% CI: 0.77-0.90, I2 = 34.1%) and 0.96 (95% CI: 0.94-0.98, I2 = 53.7%), respectively. Pooled positive likelihood ratio (LR), negative LR, and diagnostic odds ratio were 8.98 (95% CI: 4.92-16.37, I2 = 23%), 0.25 (95% CI: 0.17-0.37, I2 = 0%), and 14.98 (95% CI: 3.55-63.27, I2 = 72.9%), respectively. The area under the curve estimated by summary receiver operating characteristics was 0.86 (95% CI: 0.70-0.95). Heterogeneity induced by the threshold effect was low (Spearman's correlation coefficient: -0.30, p value = 0.62) but significant for non-threshold effect. Risk of bias and concern for applicability according to the QUADAS-2 criteria was generally low. High risk in the index test due to the absence of prespecified thresholds was a concern for most studies.

Conclusion: Based on current evidence, uCCL14 appears to have a good predictive performance for the occurrence of PS-AKI. Interventional trials to study a biomarker-guided application of AKI care bundles and RRT are indicated.

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预测持续性严重急性肾损伤的 Chemokine (C-C Motif) Ligand 14：系统综述和 Meta 分析。

简介在本系统综述和荟萃分析中，我们旨在回顾现有数据，并对尿趋化因子（CC motif）配体（uCCL14'）对持续性（≥48小时）严重急性肾损伤（PS-AKI）的预测性能进行汇总估算：我们检索了 MEDLINE、PubMed、Cochrane Library 和 EMBASE 中截至 2023 年 4 月 11 日发表的研究。我们考虑了所有包含成人并报告了 uCCL14 预测 PS-AKI 能力的研究，PS-AKI 的定义是 AKI 持续 48 或 72 小时。数据提取由一名研究者使用标准化表格完成。结果：经过筛选，我们确定了 13 项相关研究。结果：经过筛选，我们确定了 13 项相关研究，其中 4 项研究（561 名患者）提供了有关相关结果的充足数据，因此被纳入研究范围。考虑到每个研究的临界值，汇总的敏感性和特异性分别为 0.85（95% CI：0.77- 0.90，I2 = 34.1%）和 0.96（95% CI：0.94- 0.98，I2 = 53.7%）。汇总的阳性似然比（LR）、阴性似然比和诊断几率比分别为 8.98（95% CI：4.92 - 16.37，I2 = 23%）、0.25（95% CI：0.17 - 0.37，I2 = 0%）和 14.98（95% CI：3.55 - 63.27，I2 = 72.9%）。根据接收者操作特征概要估计的曲线下面积为 0.86（95% CI：0.70 - 0.95）。阈值效应引起的异质性较低（Spearman 相关系数：-0.30 p 值 = 0.62），但非阈值效应的异质性显著。根据 QUADAS-2 标准，偏倚风险和适用性关注度普遍较低。由于没有预设阈值，大多数研究都担心指数测试的高风险：结论：根据目前的证据，uCCL14 似乎对 PS-AKI 的发生具有良好的预测性。研究生物标志物指导下的 AKI 护理包和 RRT 应用的干预试验是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.